E-Mail karger@karger.com Original Paper Dig Surg 2015;32:52–59 DOI: 10.1159/000375132 Resection of Single Metachronous Liver Metastases from Breast Cancer Stage I–II Yield Excellent Overall and Disease-Free Survival. Single Center Experience and Review of the Literature Céline Vertriest   a Giammauro Berardi   b Federico Tomassini   b Rudy Vanden Broucke   a Herman Depypere   a Véronique Cocquyt   c Hannelore Denys   c Simon Van Belle   c Roberto I. Troisi   b   Departments of a  Obstetrics and Gynecology, b  General and Hepato-Biliary Surgery, Liver Transplantation Service, and c  Medical Oncology, Ghent University Hospital and Medical School, Ghent, Belgium stage III–IV at first diagnosis and number of metastases >1 was significantly associated with a shorter DFS at multivari- ate analysis (p = 0.03 and p = 0.04 respectively). Patients with multiple lesions had a median DFS of 15 months compared to 47 months in patients with a single lesion (p = 0.03). Con- clusions: Resection of single BCLM from primary stage I-II cancer offers very good long-term survival rates and a low morbidity. © 2015 S. Karger AG, Basel Introduction Breast cancer (BC) is the most frequent malignant tu- mor in women and approximately 20% of these patients experience metastases during their life [1]. Multi-site re- currences are present in most of the cases, affecting espe- cially bones and lungs. Liver parenchyma is involved in 50% of cases but isolated metastases account only for 5–10%. Unfortunately, only 2% of patients can be surgi- Key Words Breast cancer liver metastases · Liver resection · Predictive factors · Influence on survival · Literature review Abstract Purpose: Improved survival after liver resection for breast cancer liver metastases (BCLM) has been proven; however, there is still controversy on predictive factors influencing outcomes. The analysis of factors related to primary and metastatic cancer eventually influencing long-term out- comes and a review of the literature are presented in this report. Methods: Twenty-seven patients diagnosed with metachronous BCLM between 1996 and 2013 were retro- spectively reviewed. Patients who had a minimum disease- free interval between primary tumor and liver metastasis of 12 months, no more than 3 liver lesions, no macroscopic ex- tra-hepatic disease and in which systemic therapy showed a good response were included. Results: Twenty-two patients (82%) were initially diagnosed with a stage I–II disease. Twelve patients presented with multiple liver metastases. The 5 years overall survival (OS) rate was 78%, while the 5 years disease-free survival (DFS) rate was 36%. Initial tumor Received: November 4, 2014 Accepted after revision: January 7, 2015 Published online: February 11, 2015 Roberto I. Troisi, MD, PhD Department of General and Hepato-Biliary Surgery, Liver Transplantation Service Ghent University Hospital Medical School De Pintelaan 185, 2K12 IC, BE–9000 Ghent (Belgium) E-Mail roberto.troisi  @  ugent.be © 2015 S. Karger AG, Basel 0253–4886/15/0321–0052$39.50/0 www.karger.com/dsu C.V. and G.B. contributed equally to this manuscript.